Why Are Your PIP Claims Underpaid? A Unique Audit Solution in MA

Written by Marius Ged | Apr 24, 2024 5:22:33 PM

As a medical provider in Massachusetts, you may have encountered a rising issue: your Personal Injury Protection (PIP) claims are not fully paid by insurance companies

This problem directly affects your financial situation. You might be asking why this is becoming a frequent issue in healthcare. You must understand the roots of this problem and potential strategies to improve your situation.

The team at Ged Lawyers is here to help you navigate the complexities surrounding PIP coverage in Massachusetts, particularly regarding the odd phenomenon of underpaid claims. Remember, your sustainability as a healthcare provider is inherently linked with the financial balance. Let's restore that equilibrium together.

Understanding PIP Claims Reimbursement in Massachusetts

Medical providers in Massachusetts often face challenges when seeking full Personal Injury Protection (PIP) claims reimbursements. These complexities mainly stem from understanding the Commonwealth’s complex legal framework of PIP coverage.

The revenue recovery process can be a difficult task that is often outside the scope of your primary healthcare responsibilities.

The Common Barriers to Full PIP Claims Reimbursement

Insurance companies often underpay or deny the rightful Personal Injury Protection (PIP) claims reimbursement to medical providers due to several reasons.

  • Misunderstanding state laws
  • Not fully understanding the complexities of the PIP claims process
  • An underlying tendency to retain profits 

1) Misunderstanding State Laws

Firstly, PIP coverage laws in Massachusetts can be quite complex and obscure, which makes it tough for insurance companies to understand fully. 

Even though PIP claims seem straightforward, the attached legal terms are filled with fine details not always revealed by insurers. This lack of transparency can let insurance firms shortchange claims without appearing to violate the law. 

2) Miscalculating Complexities of the PIP Claims Process

Secondly, the PIP claims system, which is supposed to make it easier for medical providers, can sometimes negatively impact them due to its susceptibility to being taken advantage of by insurance companies. 

Because PIP covers a broad range of expenses such as lost wages and necessary services patients can't perform due to injury, insurance companies often conduct thorough reviews of these claims in an attempt to manage their expenses. 

3) The Profit Motive of Insurance Companies

Finally, insurance companies aim to make a profit. This unfortunate truth means they often focus on reducing costs, including lowering payouts on PIP claims. This focus on profits can lead to claims being underpaid or denied, making things difficult for medical providers in Massachusetts.

Thankfully, Ged Lawyers provides a viable solution to these prevalent issues through their unique service of conducting 6-year audits for medical providers.

This process aims to identify missing money from underpaid or denied PIP claims and recover them, allowing you to focus on your primary function - providing quality healthcare.

Unlocking Missing Money: Ged Lawyers' Unique 6-Year Audit Approach

In order to alleviate the complexity and time consumption inherent in the process of dealing with medical bills and liens, Ged Lawyers brings its unique 6-year audit approach to the table. 

Ged Lawyers offers a meticulous and refined process for managing your PIP cases efficiently and transparently. The process is detailed below to provide a better understanding: 

Phase One: Onboarding of Clients 

Our initial interaction involves reaching out for you to sign the necessary documentation. 

A designated customer service representative will set up a meeting to get acquainted with your practice and understand your unique scenario. We conduct a thorough analysis to determine the balance between physical and digital records for your practice. 

For practices primarily maintaining physical records, we utilize our cutting-edge mobile scanning trucks to efficiently and securely manage documentation. 

Our PIP Recoveries team embarks on the audit process upon establishing a viable plan. 

Phase Two: Execution of The Audit Process 

Our comprehensive audit comprises an electronic index creation, extensive data entry, and thorough analysis. First and foremost, we digitize all patient medical records into our advanced document management system. 

Subsequently, we index these digitized records with pertinent keywords to facilitate the creation of a highly accurate database. This securely accessed database can be reached from any device, whether a laptop or a mobile device, at any given time using our client portal. 

Once we've gathered all relevant data, our consultants analyze each record, identifying overlooked claims and any other vital data for PIP revenue recovery. Our lookback extends to files dating back six years! 

We also ensure user access to our claim portal is granted, allowing authorized individuals within the provider's organization and your attorney's office to keep track of each claim's status. 

Phase Three: Keeping You Updated on Our Progress 

Unlike other no-fault states like Florida, our attorneys in Massachusetts can proceed immediately to litigation without needing to file demand letters with insurance companies. 

We prepare and file demand letters and manage the entire litigation process to recover any denied or partially paid claims. Through our client portal, you remain abreast of this information. 

Details of each case from your medical provider contacts like claim receipt date, patient's name, carrier's name, dates of service, the case's current stage (demand phase, in suit, closed, or exhausted) and recovered benefits can be accessed at any time. 

Our platform allows you to swiftly and easily filter outcomes to a specific office location. PIP Recoveries ensures you're always up to date with your referral’s progress, providing you with the necessary information when required. 

Additional Perks of Our Unique Process 

Avoiding the hassle of dealing with insurance companies, litigating issues and processing payouts requires a team of legal professionals - which we provide. In addition to reclaiming unpaid or underpaid claims without hiring additional staff, PIP Recoveries notably offers: 

  • A complimentary double-check audit, even for those who’ve hired previous PIP recovery services. Our attorneys invariably find extra funds, making it worth your while to engage our services.
  • Every individual accessing patient records is HIPAA-certified and trained in the government-mandated security protocols.
  • Once a litigated case is resolved, you receive all reclaimed PIP claims including interest. The legal fees PIP Recoveries charges are the sole responsibility of the insurance company.

Availing our service costs you nothing but offers plentiful benefits. Our unique service ensures the secure handling of your practice.

Our Track Record of Success

Handling claims reimbursement can often be challenging and frustrating for many medical offices. This task, which usually involves communicating with health insurance carriers, car insurance providers, and sometimes collections agencies, can be both time-consuming and costly.

Ged Lawyers, however, has effectively helped a large number of medical providers to navigate this problem successfully. With our assistance, these health practitioners have secured millions in previously unpaid or underpaid PIP claims, saving them from incurring additional expenses. 

Thanks to our help, these healthcare providers have left behind ineffective methods of seeking payments, improved their ability to earn revenue, and expanded their service offerings.

To emphasize the impact of our service, the following success stories are noted (client identities are protected): 

An entire healthcare system was able to recover in excess of $2.8 million in underpaid or unpaid PIP claims to date, aided by Ged Lawyers. The feat began as a logistical challenge and involved organizing tens of thousands of boxes containing billing and treatment records using mobile scanning technology. 

Subsequent steps, including claim indexing, demand letter process initiation, and court case filing, were accomplished by our legal team. Importantly, the hospital did not incur any extra charges and now enjoys a consistent income stream without redirecting essential personnel to this task, thanks to Ged Lawyers, who manage this process on their behalf. 

A doctor-operated imaging company chose Ged Lawyers to clear its PIP bill backlog. The software leveraged by our team streamlined the claims processing work. Through a HIPAA-compliant portal, which the doctor accessed using secure login keys, he could monitor the reimbursement process in real time. This intervention culminated in the recovery of up to $3.7 million in medical imaging reimbursements for this enterprise. 

A chiropractic clinic sought the legal expertise of Ged Lawyers upon experiencing revenue flow complications due to underpaid and unpaid claims. The team offered a low-maintenance solution which mitigated additional work for the clinic's personnel, and this led to the acquisition of $870,000 in claim payouts from the involved motor vehicle insurance firms. 

These and numerous success stories highlight how our system has helped professionals in the health sector recover lost funds by efficiently addressing non-cooperative insurance companies. 

And this is the stance of our attorneys: 

We believe you consistently demonstrate your commitment to your patients and we, at Ged Lawyers, pledge to extend the same commitment to your medical practice. Ultimately, our mutual success is based on practicing good ethics and adhering to the rule of law to ensure accountability.

Contact Ged Lawyers Today to Start Collecting More PIP Revenue

Boasting a quarter-century of recovery experience, the dynamic legal team at Ged Lawyers is spearheaded by C. Glen Ged and Marius J. (Marty) Ged. This team of experienced attorneys is unyielding in pursuing revenue recovery for our esteemed healthcare clients. 

Operating from our headquarters in Boca Raton, and ably supported by our branch offices across the state, our team's deep expertise in Massachusetts PIP claims has resulted in the recovery of tens of millions of dollars for our partners in the healthcare sector. 

We invite you to visit the Ged Lawyers website to learn more about our services and track record of successful recoveries. 

Ready to leverage our expertise for your practice? Reach out to Ged Lawyers for a complimentary initial consultation. Our dedicated legal professionals are eager to understand and cater to the specific needs of your practice. 

If a phone call works best for you, contact us at (561) 867-4765 or toll-free at 844-4GEDLAW. We are ready to assist you in achieving maximum reimbursement on your PIP claims.